检验医学与临床2024，Vol.21Issue(14)：2025-2029,5.DOI:10.3969/j.issn.1672-9455.2024.14.009
甲状腺功能亢进症患者血清神经调节蛋白4水平及其临床意义
Level and clinical significance of serum neuregulin 4 in patients with hyperthyroidism
摘要
Abstract
Objective To investigate the level and clinical significance of serum neuregulin 4(NRG4)in the patients with hyperthyroidism.Methods A total of 69 patients with hyperthyroidism admitted and treated in this hospital from August 2019 to August 2021 were selected as the hyperthyroidism group,57 patients with subclinical hyperthyroidism admitted during the same period were selected as the subclinical hyperthy-roidism group,and 63 healthy subjects undergoing physical examination during the same period served as the healthy control group.All patients with hyperthyroidism were treated with sulfamide drug methimazole for 3 months.The levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4)and NRG4 were compared among the three groups.The changes of TSH,FT3,FT4 and NRG4 level before and after treatment in the patients with hyperthyroidism were analyzed;the value of the serum NRG4 level be-fore treatment in the assisted diagnosis of hyperthyroidism was evaluated.The correlation between serum NRG4 level before treatment with TSH,FT3 and FT4 levels was analyzed.Results The TSH level before treatment[(0.14±0.03)mU/L]in the hyperthyroidism group was lower than that in the subclinical hyper-thyroidism group[(0.25±0.04)mU/L],healthy control group[(2.61±0.45)mU/L];the FT3,FT4 NRG4 levels in the hyperthyroidism group before treatment[(15.54±2.68)pmol/L,(41.36±10.02)pmol/L,(3.42±1.12)ng/mL]were higher than those in the subclinical hyperthyroidism group[(6.25±0.27)pmol/L,(20.34±3.45)pmol/L,(2.61±0.52)ng/mL],healthy control group[(3.74±0.39)pmol/L,(12.03±2.16)pmol/L,(1.89±0.49)ng/mL],and the differences were statistical significant(P＜0.05).The levels of FT3,FT4 and NRG4 in the patients with hyperthyroidism were decreased after 1-month treat-ment[(12.04±2.41)pmol/L,(30.25±7.84)pmol/L,(2.84±0.87)ng/mL],3-month treatment[(7.65±2.23)pmol/L,(19.63±4.25)pmol/L,(2.37±0.61)ng/mL]compared with before treatment(P＜0.05).The TSH level was increased for 1-month treatment[(0.87±0.21)mU/L]and 3-month treatment[(1.42±0.32)mU/L]compared with before treatment(P＜0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of serum NRG4 for diagnosing hyperthyroidism was 0.859(95％CI=0.799-0.919,P＜0.05),the sensitivity was 66.7％,the specificity was 88.9％,the best cut off value was 2.39 ng/mL,the Youden index was 0.556.The Pearson correlation analysis showed that the NRG4 level was negatively correlated with TSH(r=-0.494,P＜0.05),and positively correlated with FT3 and FT4 levels(r=0.502,0.644,P＜0.05).Conclusion The serum NRG4 level in the patients with hyper-thyroidism is relatively high,and is decreased after sulfamides treatment;NRG4 level in the patients with hy-perthyroidism is correlated with thyroid hormone indicators levels,and has an auxiliary evaluation value for the clinical diagnosis and treatment of hyperthyroidism.关键词
甲状腺功能亢进症/神经调节蛋白4/促甲状腺激素/游离三碘甲腺原氨酸/游离甲状腺素Key words
hyperthyroidism/neuromodulin 4/thyroid stimulating hormone/free triiodothyronine/free thyroxine分类
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王丽萍,牛尚梅,柴巧英,刘云,史冬丹,李欣欣,胡新磊..甲状腺功能亢进症患者血清神经调节蛋白4水平及其临床意义[J].检验医学与临床,2024,21(14):2025-2029,5.基金项目
河北省医学科学研究课题(20210232). （20210232）
